It is not new for us to think of a matching mask or a suitable mask according to the meeting or venue. It is no more shocking for us to see fashion festivals displaying masks as a new trendsetting style statement. Not trying to disguise the pain of these times by using terms like ‘new normal’, but it would still not be wrong to say that the medical and fear instilling surgical masks have become normal for our eyes today. The new man or the so-called modern man of the 21st century is facing a pandemic and we don’t know how long it is going to last. Therefore, it is only better to get accustomed to these changes, which of course the rising consumerism does for us even before we realise it.
There was a time when the common use of such face masks was associated with East Asians. The masks are no more a medical necessity but an aesthetic statement already in their culture. Given the history of the spread of coronaviruses in East Asia during the time of the SARS epidemic (2002-2003), people had already adopted masks in their lifestyle to prevent themselves from further airborne diseases. The history of mandatory use of face masks against epidemics goes far back in time to around 1910 and 1911 – when people were encouraged to wear masks to combat the Manchurian Plague in China, and the Spanish flu worldwide.
The tales regarding the use of face masks for protection from harmful substances goes back to the Roman dynasty around 23-79 AD, when Pliny the Elder, a Roman philosopher and naturalist mentioned the use of animal bladder skins to filter dust while crushing cinnabar, which is a toxic, mercuric sulfide mineral. We also find Leonardo Da Vinci (1452-1519) insisting on the use of wet clothes over the mouth and nose as a form of protection against inhaling harmful particles. After that, in the 1700s, we see Bernardino Ramazzini, known as the father of occupational medicine advocating advancement in respiratory protection against harmful dust.
Although it is relevant to ask ourselves whether the correct way of seeing masks was as a commodity that was being ‘invented’ at various points of time in an evolving form, or not; since the practices of covering the face through veils, pagdees and safas have always existed as per the geographical and environmental needs of the region. The medical recognition in the western world and its importance in relation with the understanding of germ theory came later on, which was followed by the medical usage of the ‘surgical mask’ and the anti-pollution masks.
One of the most interesting ways in which the face mask for protection came into use was in 17th century Europe. Spooky beak wearing plague doctors of the 17th century – an image which is still a popular choice for Halloween in some regions was actually the unique mask that was worn by the doctors to prevent themselves from catching the disease. These doctors were covered with a leather headdress and a full-body gown with a beak which was filled with perfumes and aromatics to keep the bad odour away. This was the time when protection was primarily about neutralising miasma in the air, as bad odour was considered to be the reason for illness. This was done before the understanding of contagion based on germ theory was recognized.
With Alice Hamilton’s article which was published in the American Medical Association, certain experiments were reported which measured the number of bacteria that were expelled when scarlet fever patients coughed or sneezed. The bacteria expelled by doctors and surgeons when they talked or coughed while performing the surgery was also taken into consideration. The role of masks was further demonstrated by the Cambridge educated Chinese physician Wu Lien Teh during the epidemic of the pneumonic plague of Manchuria in 1910. The disease spread through airborne contact which was incredibly deadly with a 100 percent mortality rate. The region of Manchuria carried interests of three authorities at that time, that is, Chinese, Russian and Japanese empires. Therefore, immediate action was taken by contacting the foreign doctors to take charge of the situation. Dr Wu Lien Teh was appointed as the head of its anti-plague efforts. He opined that the disease did not require non-human vectors to spread it, which the rival Japanese scientists propounded. It could spread directly amongst humans through airborne contact. It was under him that the use of cloth masks was promoted and people were asked to quarantine. These cloth plague masks resembled those which already existed at that time as face protection devices but also involved multiple layers of cotton and a complex tying process to keep the mask in place for a longer time.
However, as the anthropological studies on the history of use of these face masks suggest, there are no steps of the invention of these masks. It can be made popular and accepted among people with the rising situation; however, the turn of the twentieth century already saw the emergence in the field of sanitary and biomedical technologies such as disinfection machines and anti-plague masks with different styles emerging at different places.
Mandatory usage of face masks was also seen during the 1918 global flu epidemic, popularly known as Spanish Flu. Wearing of the mask was made compulsory, failing which a person had to pay a penalty, face imprisonment, or both. The dimension of the mask was supposed to be five to seven inches wide, consisting of four layers of fine gauge with strings at four corners to keep it secure.
By the 1960s, synthetic surgical masks came to be adopted and used widely which could be disposed of after use. The 1900s also saw the use of face masks to protect against the rising pollution in workshops and mining areas. Smog masks were introduced particularly in London where the air pollution was on an extreme rise. Modern respirators to protect miners against hazardous gases and dust were also developed in the 1900s. Eventually, with the rising number of factories in the then developing countries, the requirement smog masks also went up – something which India follows as well today. However, with the advent of Covid-19, the debate to bring back the reusable cloth masks was considered – since it was the only possible solution to the rising demand and environmental needs to lessen the disposable synthetic masks.
